Beyene Habtamu, Hailu Dejene, Tadele Henok, Persson Lars Åke, Berhanu Della
Southern Nations, Nationalities & Peoples Regional Health Bureau, Hawassa, Ethiopia.
College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Acta Paediatr. 2020 Sep;109(9):1867-1874. doi: 10.1111/apa.15200. Epub 2020 Feb 17.
This study aimed at assessing the referral of sick young infants and children from the community, health posts and health centres to higher levels.
A cross-sectional survey was conducted in four of the largest Ethiopian regions from December 2016 to February 2017. Referral practices were assessed at each level in 46 districts of these regions. Interviews were supplemented by reviews of registers at health posts and health centres.
The women's development group leaders, who do not provide health services, referred half of the sick children they visited in the community to the health posts. The health extension workers referred 16% of the sick young infants and 6% of older infants and children to higher levels. From health centres, the health workers referred 6% of sick young infants and 1% of older infants and children to hospital. Many cases of possible severe bacterial infection were not referred to higher levels. A functional ambulance was available for a bit more than a third of the health centres.
Referral practices of sick young infants and children at all levels were weak that may threaten the continued reduction of child mortality in Ethiopia. Referral logistics were insufficient, which partly could explain the missing referrals of severely ill infants and children.
本研究旨在评估患病婴幼儿及儿童从社区、卫生站和健康中心向上级机构的转诊情况。
2016年12月至2017年2月在埃塞俄比亚四个最大的地区进行了横断面调查。对这些地区46个区的各级转诊情况进行了评估。通过对卫生站和健康中心登记册的审查对访谈进行补充。
不提供医疗服务的妇女发展小组组长将其在社区探访的患病儿童中的一半转诊至卫生站。健康推广工作者将16%的患病婴幼儿和6%的大龄婴幼儿及儿童转诊至上级机构。在健康中心，医护人员将6%的患病婴幼儿和1%的大龄婴幼儿及儿童转诊至医院。许多可能的严重细菌感染病例未被转诊至上级机构。略多于三分之一的健康中心有可用的功能性救护车。
各级患病婴幼儿及儿童的转诊情况不佳，这可能会威胁到埃塞俄比亚儿童死亡率的持续下降。转诊后勤保障不足，这在一定程度上可以解释重症婴幼儿及儿童转诊缺失的情况。
